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Biomedical subjects

G Ghiringhelli

Publications and source records attributed to G Ghiringhelli.

At least 37 records · Page 2Linked to original sources

Intravenous aminopropylidene bisphosphonate (APD) in the treatment of Paget's bone disease.

We studied the effect of the intravenous administration of the bisphosphonate APD in 9 patients with Paget's bone disease. The medication was given in a daily dose of 25 mg for 7 days in 0.9% saline infusion over 2 hours. At the end of treatment a significant fall of serum calcium and phosphate was observed. The urinary excretion of calcium decreased markedly and the serum levels of the mid-molecule PTH fragment increased from (mean +/- SE) 85 +/- 11 to 122 +/- 16 pg/ml (p less than 0.05). A marked and rapid decline in the hydroxyprolinuria was observed from 297 +/- 61 mg/24 h to 194 +/- 51 mg/24 h (p less than 0.01); meanwhile the serum alkaline phosphatase decreased from 102 +/- 22 to 84 +/- 21 KAU (p less than 0.05). The effect of ADP on suppression of hydroxyprolinuria varied markedly from +1 to -81% and was negatively related to the basal hydroxyprolinuria (r = -0.90; p less than 0.001). The duration of the bone turnover suppression was short. A relapse greater than 30% in hydroxyprolinuria was observed in 6 of 8 patients 2 to 3 months after APD withdrawal. The short-term intravenous administration of ADP is a useful means to rapidly suppress the activity of Paget's bone disease. However, further studies should determine the optimum dose, the length of treatment, and the need to associate oral therapy to induce a prolonged remission.

Aged↗

Comparison of the acute effect of the intranasal and intramuscular administration of salmon calcitonin in Paget's disease.

On 7 patients with mild-to-moderately active Paget's disease, 200 IU of salmon calcitonin (SCT) nasal spray (NS), induced a significant decrease of the total urinary hydroxyproline excretion (THP) during the 8-16 hour and the 0-24 hour (P less than 0.05) periods after treatment as compared to control day. However, the administration of 100 IU of SCT intramuscularly (i.m.) caused a significantly greater effect than 200 IU-NS during the second 8 hour period after its administration (P less than 0.01) and on the over-all 24 hour effect (P less than 0.05). On 3 patients with severe Paget's disease, SCT-NS was essentially ineffective whereas the injection of SCT induced a marked diminution of the THP excretion.

Administration, Intranasal↗

Acute antiosteoclastic effect of salmon calcitonin in osteoporotic women.

Twenty-one women with primary osteoporosis received an intramuscular injection of 100 IU of salmon calcitonin at 8 AM. Blood samples IU of salmon calcitonin at 8 AM. Blood samples were collected up to 5 h postcalcitonin and urine was collected for 24 h in three periods of 8 h each. A significant fall of the total hydroxyproline excretion (THP) was observed in every period but the maximum effect took place 8-16 h postcalcitonin. The effect was more pronounced in those patients with a greater basal excretion of THP and in those with a more significant diminution of their bone mass. A significant diminution of the urinary excretion of calcium was found 8-24 h postcalcitonin, while phosphate excretion increased throughout the three 8 h periods. The effect of calcitonin in osteoporotic women was compared with the results obtained in 9 patients with Paget's disease. In absolute in 9 patients with Paget's disease. In absolute values the fall of THP excretion was significantly greater in the pagetic patients but the percentage diminution was not significantly different in osteoporotic women and in pagetic patients. Salmon calcitonin induced a significant acute diminution of bone turnover in patients with osteoporosis, as defined by decreases in total urinary hydroxyproline. The calcitonin-induced hypocalcemia does not seem to be an accurate index of the hormone action in osteoporosis.

Aged↗

Cortical bone mineral content in primary hyperparathyroidism. Changes after parathyroidectomy.

The bone mineral content (BMC) of 35 patients with primary hyperparathyroidism (PHPT) was measured at the mid radius (95% cortical bone) by photon absorptiometry of a 241Am source. The majority of the patients had an overt disease of moderate to severe degree. Average serum calcium of the group was 12.3 mg/100 ml (range 10.6 to 18.0 mg/100 ml). The percentage of normality of the BMC was (Av +/- 1 SD) 75.1 +/- 13.0% for the whole group. The average increment of BMC in 14 patients 9 to 26 months after parathyroidectomy was 9.9%, with a wide dispersion. However a highly significant negative correlation (r: 0.83; P less than 0.01) was found between the initial bone mass and the percentage increment per month after surgery. No further gain was observed 2 years after parathyroidectomy except in one patient with an extremely severe bone loss. In spite of the gain obtained after surgery the bone mass remained markedly diminished in most patients showing that the cortical bone loss caused by PHPT is mainly irreversible.

Adolescent↗

Efficacy of the bisphosphonate APD in the control of Paget's bone disease.

Fifty-four patients with Paget's bone disease have been treated with the bisphosphonate APD. Twenty-six patients had not previously received treatment for Paget's disease; and 28 had been treated before with EHDP alone or in combination with calcitonin. APD was given orally in a mean dose of 500 mg daily (congruent to 6.8 mg/kg of body weight) for 4 to 12 months. Bone pain diminished or disappeared in 34 of 39 patients with symptoms. A very significant diminution of the biochemical indices of bone turnover was observed in all patients, but the responses were faster in patients who had not previously received treatment for Paget's disease. After 4 months of treatment the serum levels of alkaline phosphatase of previously untreated patients diminished from 58.8 +/- 8.0 to 20.0 +/- 3.9 KA units (P less than 0.001) and urinary excretion of hydroxyproline diminished from 108.6 +/- 16.9 to 42.4 +/- 8.3 mg/24 h (P less than 0.001). In 23 of 26 previously untreated patients the biochemical indices decreased to the normal range (complete response). A reduction of 50% or more without reaching the normal range was observed in the other 3 patients (partial response). Actuarial analysis of the duration of the effect 12 months after stopping APD disclosed that 63% of patients who had achieved a complete response but only 23% of those with a partial response were in biochemical remission. A second course of APD was administered to 11 patients. The results were as effective during the second as the first course in 9 patients, whereas 2 patients had no response to retreatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Some anamnestic and clinical parameters correlated to longterm pulmonary hypertension development in patients with chronic obstructive lung disease.

A statistical correlation between anamnestic and hemodynamic data was performed in 40 patients with chronic obstructive lung disease and pulmonary hypertension at rest. Cardiopulmonary hemodynamic performance was significantly correlated with some of the assessed parameters, especially duration of illness and symptoms generally related with airway obstruction as dyspnea, cough and sputum.

Adult↗

The treatment of Paget's bone disease with sodium ethidronate.

Of 58 patients with Paget's disease treated with disodium ethane-1-hydroxy-1,1-diphosphonate (EHDP) in doses of 20 and 10 mg/kg/day, a group of 20 patients with the oligostotic form of the disease showed a significantly greater incidence of complications, such as worsening of bone pains, when compared with a group of 38 patients with the polyostotic disease (P less than 0.05). The group of 32 patients that received 20 mg/kg/day showed a greater although not significant incidence of clinical complications than the group of 26 patients treated with 10 mg/kg/day. Bone biopsies performed in one polyostotic and three oligostotic cases who suffered episodes of bone pain worsening during treatment with 20 mg/kg/day disclosed a severe osteomalacia. Both groups treated with 20 and 10 mg/kg showed a highly significant decrease of urinary hydroxyproline (THP) excretion and of serum alkaline phosphatase (P less than 0.01) after two and six months of treatment although the trend comparison between doses was not significant. It is suggested that the dose of EHDP should be related to the extent of the disease.

Adult↗